Comprehensive Physical Examination and Laboratory Tests
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Questions and Answers

What is the forceful expulsion of stomach contents from the mouth due to involuntary contractions of the abdominal, thoracic and GI (smooth) muscles?

  • Vomiting (correct)
  • Heaving
  • Retching
  • Nausea
  • Which neurotransmitter is involved in the vomiting process?

  • Dopamine
  • Histamine
  • Serotonin (correct)
  • Acetylcholine
  • What is the common cause of acute nausea and vomiting associated with acute abdominal pain in adults?

  • Meningitis
  • Peptic Ulcer Disease
  • Chronic Pancreatitis
  • Acute Pancreatitis (correct)
  • Which metabolic disease is a cause of chronic nausea and vomiting in adults?

    <p>Hyperthyroidism</p> Signup and view all the answers

    Which medication is reported to have vomiting as a side effect in more than 5% of the cases?

    <p>Opioids</p> Signup and view all the answers

    What is the term for the relaxation of the pyloric sphincter that guards the lower end of the stomach to bring up content from the gut?

    <p>Abdominal pressure rise</p> Signup and view all the answers

    What condition involves a strong, involuntary, unproductive effort to vomit associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth?

    <p>Retching</p> Signup and view all the answers

    What is the main cause of chronic diarrhea in patients with pancreatic insufficiency?

    <p>Bacterial overgrowth</p> Signup and view all the answers

    Which virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?

    <p>Cytomegalovirus</p> Signup and view all the answers

    What is the main symptom associated with osmotic diarrhea?

    <p>Cramping</p> Signup and view all the answers

    What dietary recommendation is important for patients experiencing chronic diarrhea?

    <p>Gradual reinsertion of all foods</p> Signup and view all the answers

    What is the most appropriate treatment for moderate to severe travelers' diarrhea with fever, blood, pus, or mucus in the stool?

    <p>Empiric antibiotic therapy</p> Signup and view all the answers

    What is the main diagnostic approach for differentiating chronic diarrhea sub-types such as osmotic, secretory, and motility-induced diarrhea?

    <p>Stool electrolytes and osmolality</p> Signup and view all the answers

    What is the common cause of dysmotility diarrhea known as 'overflow' diarrhea?

    <p>Colon cancer</p> Signup and view all the answers

    What is the first step in the physical examination of a patient presenting with acute abdominal pain?

    <p>Systematic physical examination</p> Signup and view all the answers

    In the context of acute abdominal pain, which imaging modality is useful for renal stones but is not the primary investigation?

    <p>Ultrasound</p> Signup and view all the answers

    What is the most common surgical cause of acute abdominal pain in elderly patients?

    <p>Acute appendicitis</p> Signup and view all the answers

    What is the commonest cause of acute abdominal pain in women of childbearing age?

    <p>Acute appendicitis</p> Signup and view all the answers

    How is diarrhea defined?

    <p>Three or more loose or watery stools per day</p> Signup and view all the answers

    What are key questions to ask during history taking for acute diarrhea?

    <p>Duration and presence of mucus, pus, or blood</p> Signup and view all the answers

    Which is responsible for most cases of severe diarrhea?

    <p>Bacteria</p> Signup and view all the answers

    What is the general approach to evaluating acute diarrhea?

    <p>Careful history to determine symptoms' duration and characteristics</p> Signup and view all the answers

    Which stage of nutrient absorption involves the final transport of absorbed nutrients into the general circulation?

    <p>Transport into the circulation</p> Signup and view all the answers

    What is the term for recurrent, frequent, uncontrolled leakage of stool and/or stool staining for more than 1 month?

    <p>Incontinence</p> Signup and view all the answers

    What is the enzyme present in the brush border membrane of the small intestine responsible for hydrolyzing lactose found in mammalian milk?

    <p>Lactase</p> Signup and view all the answers

    In the context of constipation, what does the absence of anal wink reflex suggest?

    <p>Pelvic floor dysfunction</p> Signup and view all the answers

    What is defined as constipation that includes a constellation of symptoms such as excessive straining, a sense of incomplete evacuation, and abdominal bloating?

    <p>Chronic constipation</p> Signup and view all the answers

    What can impair the absorption of lipoproteins and lead to fat malabsorption, steatorrhea, and chylous ascites?

    <p>Obstruction in the lymphatic system</p> Signup and view all the answers

    According to the text, what is a possible cause of lymphatic obstruction that can lead to impaired absorption of lipoproteins?

    <p>Primary intestinal lymphangiectasis</p> Signup and view all the answers

    What refers to deficiencies in the process of both absorption and digestion, even though malabsorption and maldigestion differ pathophysiologically?

    <p>Malabsorption disorder</p> Signup and view all the answers

    Which condition is characterized by strong, involuntary vomiting associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth?

    <p>Cyclic vomiting syndrome</p> Signup and view all the answers

    What virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?

    <p>Cytomegalovirus</p> Signup and view all the answers

    What dietary recommendation is important for patients experiencing chronic diarrhea?

    <p>Avoid dairy products</p> Signup and view all the answers

    What is the common cause of dysmotility diarrhea known as 'overflow' diarrhea?

    <p>Small intestine bacterial overgrowth (SIBO)</p> Signup and view all the answers

    What is the main symptom associated with osmotic diarrhea?

    <p>Greasy or oily stools</p> Signup and view all the answers

    Which neurotransmitter is involved in the vomiting process?

    <p>Serotonin</p> Signup and view all the answers

    What is the term for the relaxation of the pyloric sphincter that guards the lower end of the stomach to bring up content from the gut?

    <p>Rumination syndrome</p> Signup and view all the answers

    Which metabolic disease is a cause of chronic nausea and vomiting in adults?

    <p>Addison's disease</p> Signup and view all the answers

    Which neurotransmitter is NOT involved in the vomiting process?

    <p>Acetylcholine</p> Signup and view all the answers

    What virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?

    <p>Cytomegalovirus</p> Signup and view all the answers

    What is the enzyme present in the brush border membrane of the small intestine responsible for hydrolyzing lactose found in mammalian milk?

    <p>Lactase</p> Signup and view all the answers

    What is the main cause of chronic diarrhea in patients with pancreatic insufficiency?

    <p>Impaired fat digestion</p> Signup and view all the answers

    What dietary recommendation is important for patients experiencing chronic diarrhea?

    <p>Increase fiber intake</p> Signup and view all the answers

    Which medication is reported to have vomiting as a side effect in more than 5% of the cases?

    <p>Opioids</p> Signup and view all the answers

    What refers to deficiencies in the process of both absorption and digestion, even though malabsorption and maldigestion differ pathophysiologically?

    <p>Maldigestion</p> Signup and view all the answers

    In the context of constipation, what does the absence of anal wink reflex suggest?

    <p>'Neurogenic' constipation</p> Signup and view all the answers

    Which condition involves a strong, involuntary, unproductive effort to vomit associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth?

    <p>Cyclic vomiting syndrome</p> Signup and view all the answers

    What is the enzyme present in the brush border membrane of the small intestine responsible for hydrolyzing lactose found in mammalian milk?

    <p>Lactase</p> Signup and view all the answers

    What can impair the absorption of lipoproteins and lead to fat malabsorption, steatorrhea, and chylous ascites?

    <p>Pancreatitis</p> Signup and view all the answers

    What is defined as constipation that includes a constellation of symptoms such as excessive straining, a sense of incomplete evacuation, and abdominal bloating?

    <p>Irritable bowel syndrome (IBS)</p> Signup and view all the answers

    Which neurotransmitter is involved in the vomiting process?

    <p>Serotonin</p> Signup and view all the answers

    What virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?

    <p>Cytomegalovirus</p> Signup and view all the answers

    What refers to deficiencies in the process of both absorption and digestion, even though malabsorption and maldigestion differ pathophysiologically?

    <p>Maldigestion</p> Signup and view all the answers

    What is the most common surgical cause of acute abdominal pain in elderly patients?

    <p>Mesenteric ischemia</p> Signup and view all the answers

    What is the term for a decrease in gut absorptive function not requiring iv supplementation for health and/or growth maintenance?

    <p>Intestinal insufficiency</p> Signup and view all the answers

    Which enzyme, present in the brush border membrane of the small intestine, is responsible for hydrolyzing lactose found in mammalian milk?

    <p>Lactase</p> Signup and view all the answers

    What does the term 'lactose malabsorption' refer to?

    <p>Low lactase activity without symptoms</p> Signup and view all the answers

    What can impair the absorption of lipoproteins and lead to fat malabsorption, steatorrhea, and chylous ascites?

    <p>Primary intestinal lymphangiectasis</p> Signup and view all the answers

    What is the term for infrequent, difficult passage of stool with the sensation of incomplete bowel emptying?

    <p>Constipation</p> Signup and view all the answers

    What neurotransmitter is involved in the vomiting process?

    <p>Serotonin</p> Signup and view all the answers

    What is the term for recurrent, frequent, uncontrolled leakage of stool and/or stool staining for more than 1 month?

    <p>Incontinence</p> Signup and view all the answers

    What refers to deficiencies in the process of both absorption and digestion, even though malabsorption and maldigestion differ pathophysiologically?

    <p>Intestinal insufficiency</p> Signup and view all the answers

    Which pathogen is responsible for symptoms that begin within six hours after ingestion and suggest ingestion of a preformed toxin?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    What is the appropriate initial work-up for differentiating osmotic diarrhea from secretory diarrhea?

    <p>Stool osmolality and pH</p> Signup and view all the answers

    In which condition would loperamide (Imodium) be contraindicated as symptomatic treatment?

    <p>Bacterial diarrhea with fever and bloody diarrhea</p> Signup and view all the answers

    Which diagnostic approach is usually NOT needed for distinguishing between inflammatory bowel disease (IBD) and infectious diarrhea?

    <p>Endoscopy</p> Signup and view all the answers

    What dietary recommendation is important for patients with chronic diarrhea to ensure adequate nutrition?

    <p>Gradual reinsertion of all foods</p> Signup and view all the answers

    What is the underlying cause of osmotic diarrhea?

    <p>Defects in ion absorption</p> Signup and view all the answers

    Which condition may present with greasy, floating stools as a symptom?

    <p>Pancreatic insufficiency</p> Signup and view all the answers

    "Overflow" diarrhea is often associated with which of the following conditions?

    <p>Fecal incontinence</p> Signup and view all the answers

    What is the first step in evaluating a patient with acute abdominal pain?

    <p>Physical examination</p> Signup and view all the answers

    What is the most common cause of acute abdominal pain in women of childbearing age?

    <p>Gynecologic complaints</p> Signup and view all the answers

    What condition involves a strong, involuntary, unproductive effort to vomit associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth?

    <p>Dry heaves</p> Signup and view all the answers

    What is the main symptom associated with osmotic diarrhea?

    <p>Foul-smelling, floating stools</p> Signup and view all the answers

    Which imaging modality is accurate for renal colic, appendicitis, diverticulitis, AAA, and intra-abdominal abscesses?

    <p>Computer tomography (CT)</p> Signup and view all the answers

    What virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?

    <p>Cytomegalovirus</p> Signup and view all the answers

    What neurotransmitter is involved in the vomiting process?

    <p>Serotonin</p> Signup and view all the answers

    What is defined as diarrhea that is painless and involves loose or watery stools during ≥75% of defecations for the prior 3 months?

    <p>Chronic diarrhea</p> Signup and view all the answers

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